<p class="abstract"><strong>Background:</strong> The anterior tibial spine fracture occurs almost at a same frequency both in adolescents and in adults. These injuries are often overlooked at emergency room. Stable internal fixation requires to gain optimum function of ACL by securing its length and nascent tension. We treated anterior tibial spine (ACL avulsion) fracture patient with open reduction and screw fixation.</p><p class="abstract"><strong>Methods:</strong> Study of Ten patients of anterior tibial spine (ACL avulsion) fracture, with minimum of 06 months and maximum of 18 months follow up. Classification of anterior tibial spine (ACL avulsion) a fracture done by Meyer and Mckeever. All patients operated with open reduction and internal fixation with screw via medial parapatellar approach. Functional and clinical outcome measured with Lysholm knee score at final follow up.<strong></strong></p><p class="abstract"><strong>Results:</strong> We studied 10 patients with anterior tibial spine (ACL avulsion) fractrure where mean age of patient was 36.4 years. Mean radiological healing was 10.6 weeks in anterior tibial spine (ACL avulsion) fracture. We observed mean motion of knee 133 degree in anterior tibial spine (ACL avulsion) fracture. Mean Lysholm score at final follow up was 86.8.</p><p class="abstract"><strong>Conclusions:</strong> Open reduction for anterior tibial spine (ACL) fracture provides direct visualization with easy application of screws ultimately confers stable osteosynthesis enables to start early range of motion and further rehabilitation protocol. Open reduction internal fixation is comparative less technically demanding, less expansive and gives excellent to good results as compared to other techniques.</p><p class="abstract"> </p>

<p class="abstract"><strong>Background:</strong> Fractures of patella account for 1% of all skeletal injuries. There is no universal accepted treatment for patellar fractures. After a fracture of the patella, the best results are obtained by accurate reduction and stable internal fixation. Partial or total patellectomy is generally indicated when the patella is so severely comminuted that an accurate reduction and reconstruction of the retropatellar joint surface cannot be achieved.</p><p class="abstract"><strong>Methods:</strong> The prospective study of 50 cases of patellar fractures was carried out at the department of orthopaedics for the period from May 2015 to December 2017. The maximum period of follow up was 18 months with a minimum period of follow up of 5 months (average 11.68 months). Operative treatment was done in patella fractures for more than 2 mm of articular displacement or 3 mm of fragment separation. Surgical options includes internal fixation with tension band wiring with k wire and partial patellectomy with extensor mechanism repair.<strong></strong></p><p class="abstract"><strong>Results:</strong> We have studied 50 patients where 7 cases were treated conservatively. In the present series 22 patients were treated with internal fixation out of which 13 patients had excellent results. 6 patients had good results. 21 patients were treated with partial patellectomy where 6 patients had excellent results, 11 patients had good and 4 patients had fair results.</p><p class="abstract"><strong>Conclusions:</strong> Patella should be preserved and Osteosynthesis whenever possible has better chance for excellent results. A good surgical technique, optimal operation room environment and judicious use of antibiotics will reduce the possibility of infection.</p>

Introduction: Distal radius reconstruction every time needs aggressive operative intervention is still a debate among researchers and upper extremity surgeons. There is a role of nonoperative treatment in geriatric population and unfit patients. Novel techniques and revolution of implants advocated the best clinical outcome. Materials and Methods: We conducted a prospective study of 25 patients having AO OTA type A, B & C distal radius fractures treated with volar locking plate at our institute between 2015 to 2017. We include all close injuries in skeletally mature patients between ages 20-60 years. Outcome of the study was evaluated by using the Gartland and Werley score modified by Sarmiento & Patient Rated Wrist Evaluation (PRWE) score. Results: 6 patients had AO OTA type A, 11 patients had type B and 8 patients had type C fractures. Mean palmar flexion was 77 degrees. Dorsi flexion was 82 degrees observed. Average supination and pronation were 85 & 80 degrees respectively. Radial & ulnar deviations average 11 and 25 degrees were observed. 80% of the patients had loss of radial inclination less than 9 degrees. All the patients had less than 6 mm radial shortening. Loss of palmar tilt less than 6 degrees was observed. More than 90% of the patients had excellent to good outcome based on Gartland and Werley score. Conclusions: Volar plating is a proven method of choice in majority of distal end radius fractures regardless of comminution and fragments separation.

Introduction: Fractures of phalanges are the most common fractures with Incidence of 2.9% every year. They are more common in the young to middle-aged males. The phalangeal fractures are usually considered as simple injuries. Such kind of injuries may results into deformity, if not addressed properly at beginning. Phalangeal fractures with unacceptable angulation and rotations in any plane require operative fixation. There are numbers of external fixators which are versatile in the designs but needs thorough expertise to use. We describe a simple, low cost, 'easy to construct and easy to use' external fixator which can be used for a variety of hand fractures, particularly in an emergency setting as well as definitive fixation. Method: There were 27 patients with different types of fracture of phalanges of hand in our study. Among them 19 male and 8 female patients [mean age -31.85 yrs]. There were 7 open fractures and 20 closed fractures. Out of 27 patients, 15 had fractures of proximal phalanx & 12 patients had fracture of middle phalanx. Our technique is to treat with k wire and plastic cap of spinal needle cap as a static external fixator device. One patient with tendon injury and one with skin loss which was treated by plastic surgical intervention. Result: At the end of 3 months of follow up, range of movements and TAM score out of 27 patients 19 had an excellent result (range 220-260), 5 patients had a good result (range 180-219)and 3 with fair result (range 130-179). Conclusion:This technique is simple, low cost, reproducible, easy applicabilty in the management of fractures involving the small bones of the fingers where complex fixators are not available or costly or needed expertise. Complex Unstable fractures can be converted into stable fractures by this robust and reproducible method. We recommend this simple, low cost, 'easy to construct and easy to use' fixator in the management of fractures involving the small bones of the fingers.

Background: Distal third humerus shaft fractures are difficult entity to manage with. Regional Anatomy and acting forces at the region makes its management tricky to have a good functional results. Conventional platting when used have a limited distal fragment purchased. we used anatomical precontoured single 3.5 mm locking plates in 11 patients with distal third extra articular humerus fractures. Materials and methods:We have studied a retrospective study of 11 patients presented to our institute with an extra articular distal third of humerus fracture between January 2017 to June 2018. All patients were approached through posterior midline incision. Osteosynthesis had been achieved with precontoured 3.5 mm anatomical locking plates. Minimum follow up of 6 months had been taken. (range 6-24 months).all patients had been evaluated according to mayo elbow performance score at final follow up. Results: We have evaluated 11 cases of closed distal third extraarticular humerus fractures. We have included patients with mean age of 39 years in our study. There were 8 male patients (72.73%) and 3 feamale patients (27.27%). In our study maximum numbers of patients had injuries due to road traffic accidents 8 cases (72.7%) followed by domestic fall in 3 cases. Mean Range of motion at elbow was 122.27. We found excellent results in 9 cases (81%) and good to fair results in 2 cases. None of the patient had undergone for any revision surgery. Conclusion:In the management of the extra articular distal third fracture of humerus optimal osteosynthesis with rigid fixation is required to achieve good functional outcome. Use of precontoured 3.5 mm anatomical locking plates in such fractures gives rigid fixation and allows early mobilization.